Project Summary/Abstract Research Project: Reliable electronic health record (EHR)-based clinical quality measures (CQMs) are necessary for the assessment and measurement of healthcare quality and delivery. They are also a vital tool for evaluating the impact of interventions meant to improve care. Unfortunately, stakeholders have limited assurance of CQM reliability, due in part to problems with data quality. In order to ensure the reliability and, by extension, the usefulness of automated EHR-based CQMs, I propose the following: 1) generate a better understanding of the causal relationships between EHR data quality and CQM reliability; 2) provide stakeholders with methods for the assessment of CQM reliability, based upon underlying data quality; and 3) identify provider-approved interventions for improving EHR data quality in order to improve CQM reliability. Career Goals: I am seeking a National Library of Medicine K01 Career Development Award in Biomedical Informatics for two primary reasons. First, this award would provide me with an opportunity to become an independent researcher through the protected time the award ensures and allow me to develop my expertise in key subject matter and methodological areas. Second, through the proposed research I will provide stakeholders with a deeper understanding of CQM reliability, methods to measure CQM reliability, and approaches for improving CQM reliability through interventions at the point of care, enabling the improvement of clinical care itself. My long-term goal is to become an expert in mixed-methods approaches for measuring and improving the quality of EHR data, thereby ensuring reliable and valid reuse of these data to support patient care, evaluation of patient care, and clinical research. Career Development and Training: I am an assistant professor with the Department of Medical Informatics & Clinical Epidemiology at Oregon Health & Science University. Through my department and mentors I have a unique level of access to EHR data, an existing CQM calculation engine, and various clinical environments. The career-development goal of this award period is to use these resources and the expertise of my mentors to solidify my knowledge and methodological abilities in three primary areas: 1) EHR data quality assessment and improvement, 2) mixed-methods approaches, and 3) healthcare delivery science. The projects, mentors, and consultants included in this proposal were chosen to provide me with the experience, knowledge, and expertise that will prepare me for a career as an independent researcher specializing in these areas and give me the foundation upon which to apply for a traditional funding mechanism. Specifically, the aims of this proposal have been developed to lead directly to EHR-based and documentation-level interventions intended to improve EHR data quality, CQM reliability, and the quality of clinical care overall, which will be the subject of an application building upon the work described here.